ELEMENTS

AFFECTING COLOUR
 Elements Affecting Colour

There are many variables that affect how a colour is perceived. These can be external
(environmental) or internal (physiological). The lighting conditions, the environment,
and the viewer all play vital roles in colour perception and evaluation.

NATURE OF LIGHT TO WHICH THE TOOTH IS EXPOSED3, 6, 4

The light source being used is one of the most important and frequently one of the
most neglected aspect during shade selection. Without this light, colour does not exist
Different parameters of light are related to shade selection such as its colour rendering
index (CRI), colour temperature and its nature.

In spite of this standardization, the fact remains that sunlight is available only during
the day time. Therefore, it is unreliable for dental shade selection purposes because
that requires a stable light source in the form of an illuminant. This is where the
artificial light steps in.

The clinician should try and use a source of light that contains full spectrum of rays
without the dominance of any wavelength; because when an object is viewed under
lights dominating in particular wavelengths (colour bands), that specific colour
becomes dominant to the observer.

1. INCANDESCENT LIGHT: Emits high concentration of yellow waves. It is not

suitable for shade matching. It has low Colour Rendering Index (CRI).

2. FLUORESCENT LIGHT: Emits high concentration of blue waves. It is not suitable

for shade matching. It has CRI of 50-80.

3. NATURAL DAYLIGHT: Northern daylight is considered the best because it is

closest to emitting the full spectrum of white light. It is used as the standard by which
to judge other light sources. It has CRI close to 100. Most dental offices are fitted
with incandescent and fluorescent lights.67

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(a) Incandescent light (2836 K) Tooth viewed under daylight (5500 K)

(b) Fluorescent light (4000 K)
(c) Colour corrected light (5500 K)

LIGHT INTENSITY
The intensity of light is the most common regulator of pupil diameter, which is a
crucial factor in accurate shade matching. The accurate identification of colour is only
determined at the center of the visual field (perceived by the fovea). The fovea is
located in the center of the retina and contains a high concentration of cone cells,
which provide the greatest visual acuity and most accurate colour perception. Much of
the rest is “synthesized” by the visual cortex of the brain. Therefore, the most accurate
colour reading is obtained by the human eye when the pupil is opened just enough to
fully expose the cones in the fovea. This is achieved by maintaining am lighting
intensity of 150 to 200 foot-candles, as verified by a light meter.

Light meter

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Insufficient illumination makes it difficult to discern tooth shades

Too much illumination obliterates details necessary for accurate shade matching

ENVIRONMENTAL EFFECTS ON THE PERCEPTION OF COLOUR

METAMERISM
Two objects may appear to be the same colour when viewed under particular lighting
conditions (e.g. natural daylight) but exhibit distinct colour differences when
illuminated under a light source with a different spectral composition.

ILLUMINANT METAMERISM whereby two objects may match in colour under

one illuminant but not under another. While illuminant metamerism is the most
frequent in occurrence, other forms of metamerism arise because of the differences

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that can occur in the colour vision of observers (observer metamerism) as well as in
the angle of view (geometric metamerism) or in the area of view (field size
metamerism)

PROPER SHADE SELECTION: IT’S ACTUALLY A MATTER OF CONTRAST 3

Understanding how colour perception can potentially deviate due to various contrast
effects allows the dentist to select a shade more effectively. With a working
knowledge of how opposing and adjacent colours can play tricks on the interpreter,
the chances for an accurate shade match can be improved.

SIMULTANEOUS CONTRAST
Simultaneous contrast occurs when two objects are observed at the same time. When
perceiving more than one colour at once, the brain attempts to achieve a harmonic
balance of the colours. Perception of the colour therefore is affected by two factors:
(1) Its surrounding relative lightness, making the colour appear to be dark error
lighter; and
(2) Its surrounding colour, making the colour appears to have shifted toward its
surrounding colour’s complement. Identical colours will appear to be different

VALUE CONTRAST
Visual judgment of brightness is not dependable, primarily because the relative
brightness of an object is affected by the brightness of the contrasting background or
surroundings. For example, if the surrounding background is dark, an object will
appear light. However, if the same object is placed against a lighter background, it is
perceived as darker. This illustrates that the perceived brightness can vary, even
though the reflectivity of the object is constant. This is because the retina is very
sensitive to light. It expands and contracts in response to varying light intensities as
they are interpreted by the brain. If the background is darker than the object, the retina
must adapt to the relatively brighter object, causing the brain to perceive it as brighter
than it would be if the object were viewed by itself. If the background is lighter than
the object, the opposite effect results. However, because the eye adapts much more
quickly from dark to light than from light to dark, the effect of a darker object on a
lighter background is always more pronounced.

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A practical dental example of this phenomenon is when a restoration is viewed

adjacent to inflamed gingival tissues. The redness (darkness) of the gums
(background) distorts colour perception, making the restoration (object) appear
brighter. As a result, a crown that is too low in value (dark) may be chosen. The
mistake becomes apparent when the tissues heal and the crown appears too dark
because the shade was selected falsely dark under those pretenses and poor shade
selection conditions.

Same tooth appears increasingly lighter as the backgrounds become darker

HUE CONTRAST
A colour will be perceived differently when viewed in conjunction with various
background or adjacent colours with contrasting hues. For example, a tooth or
restoration appears bluish against an orange background and purplish if the
background is yellow. When a colour is viewed simultaneously with another colour,
the perceived hue of the first colour appears more similar to the complementary
colour of the second colour. Using this contrast effect, dental professionals can
precondition their eyes when taking shades by first looking at a complementary
colour, then looking at the tooth shades. This allows the clinician to see the colour of
the tooth shades more effectively.

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When viewed against different background colour the teeth appear to take on the
hue of the background’s complementary colour

CHROMA CONTRAST
This contrast follows the same effect as the value and hue contrasts. An image
appears darker against a light background, which is low in Chroma (light), and
brighter against a more chromatic background, which is high in Chroma (dark).
However, there is a variation to the theme: the closer the tooth is to the hue and
Chroma of the surrounding background, the less visible it becomes, and therefore it is
difficult to distinguish the shade of the tooth.

Highly chromatic tooth appear more vibrant against background that is low in
chroma and less vibrant against background that is closely matches chroma of
tooth

AREAL CONTRAST
The size of the object can also influence visual colour perception. For instance, a
larger object appears brighter than a smaller object of the same colour. Likewise, a
brighter object appears to be larger than a darker object of the same size.

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Larger image appear lighter due to more area so reflects more light

Being of same shade central incisor appear lighter due to more area

SPATIAL CONTRAST
An object closer to the observer appears larger and brighter, whereas a more recessed
object appears to be smaller and not as bright. This phenomenon is frequently seen
with rotated and overlapped teeth. The recessed teeth appear to be darker. Posterior
teeth also appear to be darker, and the shadows in the mouth further contribute to this
appearance.

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Rotated/resected teeth appear darker as in second diagram

SUCCESSIVE CONTRAST
Successive contrast occurs when one colour is viewed following the observation of
another colour. The visual perception remains after the eye has left the object.
Afterimages are categorized as positive (similar) or negative (different). Positive
afterimages have the same colour as the original perception; negative afterimages
have the opposite or complementary colour to the original perception. Positive
afterimages occur following a short visual interaction, while negative afterimages
occur after long visual contact with an object. The physiochemical effect is that the
neurotransmitter “rhodopsin” in the cones of the retina are quickly depleted during
prolonged staring. Therefore, the ability to see that colour is no longer a physical
reality.

Similar or complementary afterimage of coloured tooth is seen in blank tooth after

brief or long visual contact, respectively with coloured tooth

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PHYSIOLOGICAL (VIEWER-DEPENDENT) EFFECTS

COLOUR BLINDNESS
A person with colour blindness has trouble seeing red, green, blue, or mixtures of
these colours. The term “colour vision problem” is often used instead of colour
blindness because most people with colour blindness can see some colour. Colour
blindness is caused by a deficiency in or absence of one or more of the three types of
photosensitive pigments able to detect red, green, and blue. The essential effect of
colour blindness is that hues that appear different to most people look the same to
those with colour blindness. This is a serious problem for a clinician performing shade
matching, since determining the hue, value, and Chroma of a restoration is critical to
the natural appearance of the restoration.

Colour blindness test to assess level of Reversed colour blindness test number
Sensitivity to green and yellow can be easily seen if purple red colour is
detected by cones of eyes.

AGE
Aging is detrimental to colour-matching abilities because the cornea and lens of the
eye become yellowed with age, imparting a yellow-brown bias and causing the
differentiation between white and yellow to become increasingly difficult. This
process begins at age 30, becomes more noticeable after age 50, and has clinical
significance after 60 years of age. After age 60, many people have significant
difficulties in perceiving blues and purples.

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FATIGUE
Tired eyes cannot perceive colours as accurately as alert eyes. Compromised visual
perception is the consequence of systemic, local, and mental fatigue. The inability to
accurately determine hue and Chroma is most evident during times of fatigue; in
addition, colour may be perceived as faded or blurry. Fatigue is the most common
cause for an inaccurate shade match.

NUTRITION
An individual’s eating habits play an important role in the health of the eye. Some
scientists have suggested that there is an association between macular degeneration (a
physical disturbance of the center of the retina, called the macula, which causes
gradual loss of vision) and a large intake of substances high in saturated fat. There is
also evidence that eating fresh fruits and dark green, leafy vegetables may delay or
reduce the severity of macular degeneration. Additionally, supplementation with
antioxidants such as vitamins C and E has been shown to have positive effects in
slowing the progression of the disease in some cases. Other trace minerals and
nutrients such as zinc and lutein are also important for the health of the eyes.

EMOTIONS
Colour can function as a language. For example, in many places throughout the world,
red suggests anger or passion, yellow represents joy, and blue are associated with
sadness. It is generally known that emotion can affect pupillary diameter, causing
dilation or constriction, and, as stated in the previous discussions about light intensity
and light/dark contrast, pupillary diameter has a direct effect on colour discrimination.

MEDICATIONS
The abuse of drugs, alcohol, and caffeine impair not only judgment, but also colour
perception. In addition, many prescription and even over-the-counter medications are
associated with visual side effects. Medications can act on any part of the visual
system, from the visual cortex to the retina. Like all drug side effects, they vary from
person to person. Viagra, a drug used to treat erectile dysfunction, is notorious for
causing vision to have a blue tint, which makes it difficult to distinguish between blue
and green. Of special concern for dentists, particularly female practitioners are the

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side effects caused by oral contraceptives (i.e., red-green or yellow-blue

discrimination defects). They also can cause a blue tinge, and there are several studies
that indicate that long-term use of oral contraceptives causes a decrease in colour
perception of blues and yellows.

BINOCULAR DIFFERENCE
The perception difference between the right eye and then left eye is called binocular
difference. It often becomes evident during an eye exam when a person can see the
vision chart better with one eye than the other. While colour disparity between a
person’s eyes is relatively minor, one should be aware of it and, if necessary,
compensate for it. To check for binocular colour difference, two objects are placed
side by side under uniform illumination. They may appear different. A binocular
colour difference exists if the object on the right still appears lighter when the
placement is reversed.

When two objects of same shape and colour If two objects are placed on
same
Are arranged side by side they may appear side effect is not evident
to be different

COLOUR VISION PROBLEM/COLOUR BLINDNESS

Most complex and misunderstood area of colour sensation is the detection of radiant
energy by the receptors in the human eye and the interpretation of this visual
stimulation by human brain.

Colour blindness is caused by a deficiency in or absence of one or more of the three

types of photosensitive pigments able to detect red, green and blue.

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Different types of colour vision confusion exist:

• ACHROMATISM: Complete lack of hue sensitivity

• DICHROMATISM: Sensitivity to only two primary hues usually either red or green
is not perceived

• TRICHROMATISM: Sensitivity to all three hues with deficiency or abnormality of

one of the three primary pigments in the retinal cones.1

MATERIALS SELECTION:

PHYSICAL AND OPTICAL PROPERTIES OF THE TOOTH BEING VIEWED

The most important physical property related to a tooth’s shade is its moisture
content. If any tooth is allowed to dry out, its colour tends to appear lighter and less
saturated. This drying out occurs towards the end of a dental procedure, especially
under rubber dam isolation and while making addition silicone impressions. It then
takes almost 20–30 minutes for the tooth colour to return to its baseline values. Hence
it has been recommended to make shade selections at the start of a dental procedure
rather than at its end.

The optical properties of a tooth result from an interaction between its internal
structure (pulp, dentinal tubules and hydroxyapatite crystals) and external features
(tooth size, shape and surface texture). Earlier research by Ten-Bosch and Coops
showed that dentine was responsible for imparting the basic tooth colour, which was
further modified by its external features. Dozic et al has revealed that the combined
effect of all internal structures causes light to be reflected at the surface and absorbed
within tooth substance, thereby making a certain tooth shade visible.

The choice of material is extremely important to determine the accuracy of a shade.

The relative translucency of the tooth to be matched and the material selected must
coincide. Bleached teeth can be especially problematic to match. This is because
colour is achromatic; hue is white, Chroma is low, and value is high. Value is the only

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tangible parameter that can be addressed, but it relates to opacity and translucency.
Therefore, material selection is significantly more important. Certain materials are
higher in translucency (synthetic ceramics) while others are higher in opacity
(zirconia and alumina); therefore, identification of the material’s inherent qualities is
imperative when quantifying shade. These qualities, fluorescence, opalescence, and
translucency, make up the “optical triad,” and it is the job of the dentist technician
team to recognize and account for those variances.

TRANSLUCENCY
Generally, increasing the translucency of a crown lowers its value because less light
returns to the eye. With increased translucency, light is able to pass the surface and is
scattered within the restoration. The translucency of enamel varies with the angle of
incidence, surface texture and luster, wavelength, and level of dehydration.

SURFACE TEXTURE
Sulikowski et al. explained that surface texture influences aesthetics by determining
the amount and direction of light reflected of the facial surface. Texture should be
designed to simulate the reflectance pattern of the adjacent natural teeth. Young teeth
may have a lot of characterization with stippling, ridges, striations, and lobes. These
features may be worn away with age leaving smoother, highly polished surfaces.

FLUORESCENCE
It is the absorption of light by a material and the spontaneous emission of light in a
longer wavelength. Vital teeth look brighter and alive as higher amount of organic
material is present. Laren stated that the more the dentin fluoresces, the lower the
chroma. These powders are added to crowns to increase the quantity of light returned
back to viewer and to decrease the chroma.

OPALESCENCE
It as a phenomenon in which a material appears to be one colour when light is
reflected from it and another colour when light is transmitted through it.

AFTER IMAGE AND VISUAL DISTORTION

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Fondriest stated that after images are frequent physiologic effects of the cone
receptors with normal function that cause alterations in the perception. It includes
spreading effect: when light is removed from the retina, the receptors continue for a
short time to be active and send signal to the brain.

BRUNESCENCE
Pensler defined it as the natural browning of the cornea that occurs with age. It acts as
a filter and changes the appearance of colours. Hence, the age of the dentist also
forms an important factor in shade determination.

APPERCEPTION70
Apperception is how the mind interprets what the eye perceives. Optical illusions
exemplify the perception and apperception phenomenon. Shade selection is a
combination of perception and apperception, and hence involves a thought process.

BLEACHING
In bleached tooth, value of the teeth increases, making them whiter. Therefore,
bleaching teeth is associated with a loss of coloured pigments. Bleaching does not
necessarily imply that the teeth are becoming more opaque and reflective. It means
that intrinsic coloured pigments are removed and a tooth can become whiter yet can
remain highly translucent. Bleaching is performed through the application of a gel
containing oxidants (i.e., carbamide-peroxide). Oxygen radicals released from the gel
penetrate the enamel and oxidize many of the dark colourants in the dentine layer that
may be of intrinsic or extrinsic origin. The structure of the teeth remains the same, yet
the value of the teeth increases. Changes in operatory lighting, fatigued eyes, and
various contrast effects can create optical illusions.

Bleached teeth are more difficult to match as they are devoid of hue and chroma

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